Get Mountainview Cardiovascular & Thoracic Surgery Controlled Substance Agreement 2016-2025

Filling out the MountainView Cardiovascular & Thoracic Surgery Controlled Substance Agreement online is a straightforward process. This guide will walk you through each step to ensure that you understand and complete the agreement accurately.

Follow the steps to fill out the agreement online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name in the ‘PATIENT NAME’ field followed by your date of birth in the ‘DOB’ field. This information confirms your identity and supports proper documentation.
3. Read through the purpose of the Agreement to understand its significance regarding prescribed controlled substances. This sets the foundation for the mutual trust necessary in the provider/patient relationship.
4. Initial next to each statement to indicate your understanding and agreement. Pay close attention to the responsibilities outlined, such as notifying your provider of prescriptions from other providers.
5. Provide your pharmacy information, including the name, address, and telephone number. This will indicate where your medications should be filled and is crucial for compliance.
6. Review the commitments related to the use of controlled substances and acknowledge your responsibilities concerning medication management and communication with your provider.
7. Sign and date the agreement at the end, confirming your acceptance of the terms outlined. Ensure that the date and time are accurately recorded.
8. Finally, save your changes, download, print, or share the completed form as necessary to maintain your records.

Complete your MountainView Cardiovascular & Thoracic Surgery Controlled Substance Agreement online today!